Why Didn't Va. Expand Medicaid? Don't Trust Federal Promises, Governor Says

By Susan Jones | November 14, 2013 | 9:14 AM EST

Virginia Gov. Bob McDonnell (R) (AP File Photo)

(CNSNews.com) - As more and more Democrats point accusing fingers at states that have opted not to expand their Medicaid programs, Virginia Gov. Bob McDonnell said for him, it's a question of Medicaid reform  -- and whether the federal government will keep its promises to the states.

"I mean, the federal government's broke. $17 trillion in debt -- 100 percent for three years, and 90 percent thereafter -- I'm not sure they can do it," McDonnell told MSNBC's "Morning Joe" on Thursday.

Under the Affordable Care Act, Medicaid will be expanded on Jan. 1 to include individuals between the ages of 19-65 with incomes up to 138 percent of the federal poverty level -- $15,856 for a single person. The federal government has promised to pay 100 percent of the cost for newly eligible adults for three years, and 90 percent of the cost thereafter.

Do you actually think they wouldn't write the check? one of the hosts asked McDonnell.

"Well, they might for a year or two, and then times get a little bit tougher, and you gotta balance the budget. We're heading south already with deficits...but here's the real reason: What we've said in Virginia is we're  not opposed to it (Medicaid expansion) philosophically, but until we have dramatic reform in the Medicaid system that's grown 1600 percent in 30 years from 5 percent to 21 percent of the total budget of Virginnia -- until  we got some significant reforms -- deal with dual eligibles and co-pays and some other things...it wouldn't be responsible to do that.

"It's busting most budgets...of the states. And so we're down the path of reform now about eight months. We've made a lot of reforms, and there may be a time when that (Medicaid expansion) happens."

Only 25 states and the District of Columbia have agreed to expand their Medicaid programs. Speaking in Florida last Friday, President Obama blamed "politics" for the refusal of the other states.

"Here in Florida, we have the possibility of making sure that over a million people who don't have health insurance could get it right now and wouldn't have to go through a website," Obama said. "We're working on that, but in the meantime, Medicaid expansion is something that you've already seen a number of states have done. And right away, you've got hundreds of thousands of people who have health insurance that didn't have it before. We could be doing it right now. It's not happening, because of politics."

Cuccinelli's loss

On another topic, McDonnell said there's no single reason that Republican Ken Cuccinelli lost the Virginia governor's race, but the government shutdown did not help.

"I do think that when that government shutdown occurred, which was really  not smart tactically on my party. I didn't think the president led, but I didn't think our team was smart in trying to defund Obamacare, which was never going to happen -- Harry Reid and President Obama were never going to agree to that. So that hurt tremendously.

"If that last five weeks of the campaign had solely been a referendum on Obamacare and all the problems we saw with the implementation, I think that might have tipped it in his favor. But the shutdown was folly, and didn't accomplish anything."

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